Ambulatory Surgery Center Fee Schedule - Washington Department ...
Ambulatory Surgery Center Fee Schedule - Washington Department ...
Ambulatory Surgery Center Fee Schedule - Washington Department ...
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DOC ASC <strong>Fee</strong> <strong>Schedule</strong><br />
Effective Dates of Service 7/1/2012 thru 8/31/2012<br />
Refer to the 2012 CPT® and HCPCS coding books for complete code descriptions<br />
Procedure<br />
Code<br />
Allowed<br />
Amount<br />
Multiple<br />
Procedure<br />
Discounting<br />
36831 $2,569.76 Y<br />
36832 $2,569.76 Y<br />
36833 $2,569.76 Y<br />
36835 $1,946.37 Y<br />
36838 $2,569.76 Y<br />
36860 $150.50 Y<br />
36861 $1,946.37 Y<br />
36870 $2,933.42 Y<br />
37183 $6,112.77 Y<br />
37195 $150.50 Y<br />
37200 $1,912.51 Y<br />
37201 $1,121.11 Y<br />
37202 $1,121.11 Y<br />
37203 $1,912.51 Y<br />
37204 $5,863.55 Y<br />
37205 $6,112.77 Y<br />
37206 $6,112.77 Y<br />
37207 $6,112.77 Y<br />
37208 $6,112.77 Y<br />
37209 $1,912.51 Y<br />
37210 $6,112.77 Y<br />
37250 Packaged N<br />
37251 Packaged N<br />
37500 $2,829.18 Y<br />
37501 $1,669.47 Y<br />
37565 $2,236.55 Y<br />
37600 $2,236.55 Y<br />
37605 $2,829.18 Y<br />
37606 $1,669.47 Y<br />
37607 $1,669.47 Y<br />
37609 $1,099.36 Y<br />
37615 $1,669.47 Y<br />
37620 $2,829.18 Y<br />
37650 $1,669.47 Y<br />
37700 $1,669.47 Y<br />
37718 $1,669.47 Y<br />
37722 $2,829.18 Y<br />
37735 $2,829.18 Y<br />
Procedure<br />
Code<br />
Allowed<br />
Amount<br />
Multiple<br />
Procedure<br />
Discounting<br />
37760 $1,669.47 Y<br />
37761 $1,669.47 Y<br />
37765 $1,669.47 Y<br />
37766 $1,669.47 Y<br />
37780 $1,669.47 Y<br />
37785 $1,669.47 Y<br />
37790 $2,191.74 Y<br />
37799 $38.53 Y<br />
38120 $2,942.95 Y<br />
38129 $2,390.93 Y<br />
38200 Packaged N<br />
38204 Packaged N<br />
38206 $750.34 N<br />
38220 $194.76 Y<br />
38221 $194.76 Y<br />
38230 $2,093.53 N<br />
38240 $2,093.53 N<br />
38241 $2,093.53 N<br />
38242 $750.34 N<br />
38300 $793.02 Y<br />
38305 $1,219.29 Y<br />
38308 $1,546.53 Y<br />
38500 $1,546.53 Y<br />
38505 $490.98 Y<br />
38510 $1,546.53 Y<br />
38520 $1,546.53 Y<br />
38525 $1,546.53 Y<br />
38530 $1,546.53 Y<br />
38542 $3,063.34 Y<br />
38550 $1,546.53 Y<br />
38555 $1,546.53 Y<br />
38570 $2,942.95 Y<br />
38571 $4,583.95 Y<br />
38572 $2,942.95 Y<br />
38589 $2,390.93 Y<br />
38700 $1,546.53 Y<br />
38720 $1,546.53 Y<br />
38740 $3,063.34 Y<br />
CPT® codes only are copyright 2012 American Medical Association. All Rights Reserved. Applicable FARS/DFARS apply<br />
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